What It’s Like to Apply for Health Insurance in 2013

In October 2011, I got laid off. It was a department-wide layoff, and I was definitely the most excited person in the room. I was doing math while HR spoke to us about not coming back to the office drunk and kicking over desks. By the end of the HR director’s Office Space routine, I’d figured out that I’d get 12 weeks of severance — plenty of money to start up my own business, which is what I’d been wanting to do for at least two years.

Even better, I’d get COBRA for 18 months, starting at the end of my severance. My health insurance was pretty spectacular, and I wanted to hang onto it as long as possible. If I’d known then when I know now, I would have clung to it even more tightly.

Fast forward to May, 2013. My COBRA, I knew, would come to an end as of July 31. Being a thorough type of person, I decided to start researching right away, to make sure that I’d have the best possible coverage by the time my old insurance was through.

Well.

It turns out, in 2013, there is not such thing as good coverage for a sole proprietor. There is either shitty coverage, for a lot of money each month, and a medium-sized deductible, or OK coverage, for a lot of money each month, and a gigantic deductible. There are other options, where I believe they just come over to your house, take all your old stereo equipment and your wedding rings, have sex with your spouse, break your knees, and leave, but you can usually avoid that, as long as you’re not overweight.

I’m mostly kidding.

My actual options were:

1. Health insurance plan A, the HMO version of my awesome coverage from my old company. This would be through Adam’s student association, and seemed pretty great — except that he’d have to switch to it, too, and we’d have to pay up front for the rest of the year, to the tune of about $3,000. Pass.

2. Health insurance plan B, through the same company that insures NYC teachers, firemen, cops, and sanitation workers. Accepted by no one, because fuck all those useless people, right? Who do they think they are? This one was reasonably priced, meaning that it only cost as much as my rent each month.

3. Health insurance plan C. High deductible, just about the same rate as plan B, accepted by all my doctors. Available through one of my professional associations. I went with this one, for obvious reasons. By the time I work through the deductible, though, it’ll be 2014, and I’ll have to start over again. But at least if I get really sick, I’ll be covered.

I filed my paperwork and sent in my binder check, and waited. And waited. And waited. Two weeks before my insurance was due to start, I realized I might want to figure out if I’d been accepted. I called the office, instigating a massive search for my paperwork. While they looked, I went through the following scenarios in my head:

1. They’ve lost the paperwork for good, which means that my check and tax documents are just … out there, somewhere, waiting for someone to steal my identity.

2. They have my paperwork, but I’m being rejected for having used my old health insurance too much, and everyone at the insurance office is fighting over who has to be the person to tell me.

3. Option No. 2, plus all the other health insurance companies will reject me, and I won’t be able to get any health insurance, and I’ll wind up on NY1 telling everyone my sad story. Or more likely, I’ll set up an interview with NY1, and then get hit by a bus on the way over. While I’m flattened on the road, the emergency services people will lean over and whisper gently in my ear, “What insurance do you have?” And I will immediately expire from rage and frustration.

Shortly after my heart rate hit 150 and I started feeling lightheaded, the insurance office wrote to say my application was processing and everything looked good. I lay down on the rug and started doing Lamaze, although I am not pregnant and can’t afford to have a baby, even with health insurance.

Anyway, I’m telling you all this so that you’ll understand what it’s like in my head at all times, and also what it’s like to try to get insurance right now. I’ve heard a lot of horror stories about what’s going to happen to us when Obamacare goes through, and maybe it’ll be a nightmare hellscape, but I have to say, trying anything at this point is better than trying nothing. Let’s all keep our fingers crossed that things get better, not worse.

7 thoughts on “What It’s Like to Apply for Health Insurance in 2013”

Living in a place where getting good healthcare is easy, this is something I absolutely fail to understand. America is better than this. And how can a party that claims to be pro-business and want people off welfare not support it? How many more people would be able to be entrepreneurs if they didn’t have to fear that their family would be unable to be covered by insurance? How many jobs could be freed up if the people who wanted to be could more easily be self-employed? How many more amazing full-time authors and artists would we have? How many incredible concepts have we never heard of because people who would develop them were chained to full-time jobs by healthcare? It’s sickening.

I thought about enrolling at the state college part-time, just for insurance. Then I found out the insurance they offer is awful and you have to go to their doctors. In addition, I’d have to come up with tuition, but at least I would be learning something rather than just giving an insurance company my money. The current policy I have pays nothing unless I go into a hospital of their choice.

If I do go to the hospital I have to be very careful not to use too many bandages, use the phone, turn on the television or ask for another pillow and blanket. My insurance does not cover those luxury items.

Oh, and let’s hope that I don’t have to go to physical therapy after I get out…another thing that is not covered. If they think the doctor ordered one too many scans, guess what? It is haggle time to get them to apply it to my deduction, which will never be met.

I don’t even mention my insurance when I go to the doctor because they give a better rate to the uninsured. Did I mention that I’ve had it for six years and never filed a claim, but every year it goes up by $65 or more a month?

Feeling totally ripped off, I decided I would just drop it all and go to a charity hospital if need be, but then I found out starting next month (I believe) anyone without insurance will be fined by the federal government and each year the fine increases.

Now my plan is, to get a crappy insurance that doesn’t pay anything, because my good insurance doesn’t either, and when the hospital bill shows up I will use the good faith plea and pay $20 a month until I die. As long as you pay something and they accept it, they cannot ruin your credit rating.

Since the time that I’ve been self-employed (6 years) I have spent $42,400 and not filed a claim. Had I put my monthly insurance premium in the bank for medical emergencies and let it earn interest, I think I would have come out ahead of the game. Soon even that option will be illegal.

Suggestion – Be sure that you will have the option to get on your husband’s insurance later if you decide you need to, because sometimes that is a onetime option. If you do have the option again, it may require that you pay to have a few different doctors examine you and report that you are healthy. Insurance companies only like to insure super healthy people.

Also, you could go the crappy route and get the cheap insurance and your husband’s insurance as a supplemental, especially if it covers doctors visits and medicines. It might be worth it if coming up with all of it at once is only for the remaining part of this year and not every year that you will be on his insurance plan.

There is also a writers group based out of New York that has some kind of group insurance. I believe there is an annual fee to join the group, but if you can get group insurance, it might be worth it.

Keep shopping around. Be prepared though, if you decide to drop the plan you are on you will have to show proof that you are insured by another company because it’s illegal not to be insured, even if it means that you have to go down to just eating one meal a day.

Jumping ahead 10 years, my total investment in insurance for 16 years will be around $120,400. That is insane, unless of course I end up in the hospital for a heart transplant, that is, if they cover it.

I looked into Freelancer’s Union, and if I were 22 and didn’t see any specialists, I’d totally do it. Their insurance is some weird variation on BCBS that’s administered through Anthem. (Or the other way around. I get confused.) Long story short, my doctors don’t take it.

Adam’s a student, so he has the crappy student insurance of which you speak. It’s fine for what he needs, but again, it’s really geared toward a young, healthy person who just needs a checkup before starting an internship.

I wound up going with an insurer I found through one of my professional associations. My doctors take it, although I probably won’t meet the deductible before the end of the year. But at least I don’t have to worry that a trip to the ER will bankrupt us.

I still do physical therapy, once a week starting next week, and I’ll pay for that out of pocket. I guess, as you say, the only upside is that it’s a tax deduction.

I pay for insurance for me and my daughter because — believe it or not — it’s less than what it costs for the family plan through my employer. If I had 5 people to get coverage for, it would be great, but it’s just me and my daughter. Or if it were just me, that would be cost-effective as well.

And going from a great employee-provided insurance plan that I had at a previous employer to a lesser one where the insurance company seems to make all the decisions about what is good for us (rather than the doctors) is a huge adjustment. I hate insurance companies. My premium goes up every year, but I don’t get anything more from it — just more restrictions.

One good thing is when I signed up for my plan, I was given a plan they don’t offer to new people anymore. I asked about different plans with the hope of reducing my monthly premium, but the coverage (percentage covered, out of pocket expenses, deductibles) I receive is the best for the amount I pay. So unless, they eliminate the plan, I will stick with it.